Emergency Departments: An Underutilized Resource for Expanding COVID-19 Vaccine Coverage in Children

Area of Science:

• Pediatrics
• Public Health
• Vaccinology

Background:

• Suboptimal COVID-19 vaccine (CV) acceptance in children necessitates innovative strategies for immunization.
• Pediatric emergency departments (EDs) offer a unique setting to reach underserved children for vaccination.
• Limited data exists on the current availability and scope of CV programs within US EDs.

Purpose of the Study:

• To determine the prevalence of CV programs in US pediatric EDs.
• To assess the number of CVs administered annually in these settings.
• To identify facilitators and barriers to CV administration in EDs.

Main Methods:

• A cross-sectional survey was distributed to pediatric ED physicians nationwide.
• The survey collected data on EDs offering CVs, vaccine administration volume, and perceived facilitators/barriers.
• Chi-square tests were used to compare factors among different vaccination frequency groups.

Main Results:

• Responses were received from 142 physicians representing 61 EDs (37.3% response rate).
• Only 11 EDs (18.0%) reported offering at least one CV annually, with just two administering ≥50 CVs.
• Key facilitators included EHR integration, provider buy-in, and accessible vaccine storage; barriers included patient refusal and missed opportunities.

Conclusions:

• CV programs are currently uncommon in US pediatric EDs, with low vaccine administration numbers.
• Despite low current rates, a majority of surveyed EDs (59.6%) expressed interest in establishing CV programs.
• Targeted interventions addressing identified barriers and leveraging facilitators could enhance pediatric vaccination in ED settings.